Association between adenotonsillar hypertrophy, tonsillitis and painful crises in sickle cell disease

J Pediatr (Rio J). May-Jun 2009;85(3):249-53. doi: 10.2223/JPED.1898.
[Article in English, Portuguese]

Abstract

Objectives: To determine the prevalence of obstructive adenotonsillar hypertrophy in children and adolescents with sickle cell anemia; to investigate possible association between the presence of more than five episodes of tonsillitis in the last 12 months and episodes of painful crises in the same period; and to compare the mean annual hemoglobin level in children and adolescents with and without obstructive adenotonsillar hypertrophy.

Methods: Prospective, observational, cross-sectional study involving 85 children and adolescents with sickle cell anemia. All patients answered a questionnaire and underwent a standard otolaryngology examination, including endoscopic endonasal approach. The diagnosis of obstructive adenotonsillar hypertrophy was made according to the Brodsky scale.

Results: The prevalence of obstructive adenotonsillar hypertrophy was 55.3%. Obstructive adenotonsillar hypertrophy was associated with history of difficulty in eating (76.7 vs. 23.5%, p = 0.003), presence of more than five episodes of tonsillitis in the last 12 months (70.6 vs. 29.4%, p = 0.021), loud snoring (73.0 vs. 27.0%, p = 0.004), and sleep apnea (71.8 vs. 28.2%, p = 0.005). Patients with obstructive adenotonsillar hypertrophy had more episodes of recurrent upper airway tract infection (62.5 vs. 37.5; p = 0.010). The presence of more than five episodes of tonsillitis in the last 12 months was associated with episodes of painful crises (median = 12 vs. 2, p = 0.017). There was no significant difference between mean annual hemoglobin levels of patients with obstructive adenotonsilar hypertrophy vs. nonobstructive adenotonsillar hypertrophy: 7.6 vs. 8.2 g/dL, p = 0.199.

Conclusions: The prevalence of obstructive adenotonsillar hypertrophy was 55.3% in children and adolescents with sickle cell anemia; the presence of more than five episodes of tonsillitis in the last 12 months was associated with episodes of painful crises in the same period; and there was no difference in the mean annual hemoglobin value among those with or without obstructive adenotonsillar hypertrophy.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adenoids / pathology*
  • Adolescent
  • Anemia, Sickle Cell / blood
  • Anemia, Sickle Cell / complications*
  • Brazil / epidemiology
  • Child
  • Epidemiologic Methods
  • Female
  • Hemoglobins / analysis
  • Humans
  • Hypertrophy / epidemiology
  • Hypertrophy / pathology
  • Male
  • Pain / complications*
  • Pain / epidemiology
  • Palatine Tonsil / pathology*
  • Tonsillitis / complications*
  • Tonsillitis / epidemiology

Substances

  • Hemoglobins